Provider Demographics
NPI:1487686317
Name:CORREA COLON, HECTOR A (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:A
Last Name:CORREA COLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 196
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0196
Mailing Address - Country:US
Mailing Address - Phone:787-737-4333
Mailing Address - Fax:787-737-5022
Practice Address - Street 1:CALLE SANTIAGO NORTE #104
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-737-4333
Practice Address - Fax:787-737-5022
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5552261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care